[Equipment] Need help finding machines to try

[markrb]

I am a long time sleep apnea sufferer and in the past I have never been able to use a machine. I have tried all kinds of other therapies with only partial success. It's been over ten years since I tried to use a machine and I think it's time to try one again and my doctor agrees.
We are hoping that with the advancements in technology, my willingness to give it a real try and maybe some anxiety meds to get me started we can be successful.
I really don't know much about these machines, but do know some things my doctor wants to make sure the machine has. The biggest requirement is that it needs auto tritration (sp?). I believe most these days have data collection.
What is really important to me is that we find one that lets me breathe as naturally as possible when I am awake. I become terrified when I feel like I can't breath out.
She suggested looking at the Fisher and Paykel machines with Senseawake.

Do others have something similar or may even work better?

Once I am asleep I think or at least I hope I won't have a problem.

Thanks,
Mark

[Paptillian]

I'm still new around here but I can share what I've learned.

From Resmed, maybe the S9 Autoset (not the Escape Auto) could be an option for you as well. It's an auto-CPAP which adjusts pressure automatically. It has Expiratory Pressure Relief (EPR) to help you breathe out comfortably.

Just about all the CPAPs collect some sort of data for insurance/compliance purposes, but the S9 Autoset also collects efficacy data that you can use to track your treatment progress. Most folks here highly recommend that.

The Resmed Escape Auto doesn't collect the efficacy data, so it's one to avoid.

Also, don't be fooled by the Resmed Elite. "Elite" doesn't mean it's the best machine they make. It's just the best of the straight CPAP machines (non-Auto) which does collect efficacy data but doesn't adjust pressure.

[PollCat]

I agree with Paptillian regarding the S9 auto, since its my latest machine. Philips Respironics has a similar unit (for le$$ than the S9) but I found it to be too noisy for my sleeping comfort. However, there are several members of this forum that use/like the Respironics machine.

[trish6hundred]

Hi markrb,
WELCOME! to the forum.!
Check out the following link; it's very good information on which machines to buy. http://www.apneaboard.com/wiki/index.php...ne_Choices
Best of luck and hang in there for more responses to your post.

[markrb]

Thanks for the advice and I will definitely look into that machine.

Regarding the Fisher and Paykel machines with Senseawake is that just a marketing term for what the S9 does or is that something more?

I am really worried about having a panic attack and being able to breathe out easily when awake is extremely important to me.

Thanks,
Mark

[zonk]

Senseawake drop the pressure to the lowest level when machine detect that you,re awake so its not the same as ResMed EPR (Expiratory Pressure Relief) or Repironcis Flex.
EPR drop pressure as you exhale, some find breathing out at lower pressure more comfortable

Pressure drop determined by what setting chosen from 3 setting levels
Setting 1 ... drop pressure by 1 cm
Setting 2 ... drop pressure by 2 cm
Setting 3 ... drop pressure by 3 cm

EPR does not drop pressure below 4 regardless of the setting

As for machine choices, stick with ResMed S9 AutoSet/Elite (not Escape or Escape Auto) or PRS1 Auto 560/Pro 460 (Plus/SE models and numbers below 460 are not data capable machines)

Unlike F&P Icon ... both (S9 and PRS1) distinguish an obstructive apnea from clear airway apnea, uses SD card and supported by free readily available software

[RonWessels]

You seem a prime candidate for the ramp feature on most new model machines. This is a feature whereby the initial pressure settings are very low and are gradually raised over time (up to 45 minutes) as you fall asleep.

When I first started, I found the feature invaluable. After about a month and a half of CPAP experience, I no longer use it. From what I have read, most people (myself included) get used to the pressure and in fact find that the lower pressure seems to be "not enough air".

In terms of panic at not being able to exhale, as I mentioned in another thread, after just over a month of usage, I now wake up not even noticing the extra pressure. In fact, it took active concentration and lifting my mask away from my face to realize not too long ago that we had a power failure and the machine was no longer working/powered.

Of course, the problem is getting over the initial acclimation and panic attacks. All I can say is that if you stick with it, it does get better.

[vsheline]

I am really worried about having a panic attack and being able to breathe out easily when awake is extremely important to me.

EPR drop pressure as you exhale, some find breathing out at lower pressure more comfortable

Pressure drop determined by what setting chosen from 3 setting levels
Setting 1 ... drop pressure by 1 cm
Setting 2 ... drop pressure by 2 cm
Setting 3 ... drop pressure by 3 cm

EPR does not drop pressure below 4 regardless of the setting

Hi markrb, welcome to the forum!

Many people find the easiest machines to breath out against are the bi-level machines which can lower the pressure as much as 10 (cmH2O) whenever you are exhaling. As Zonk mentioned, ResMed EPR (and Philips Respironics C-flex and A-flex) can only be adjusted to relieve the pressure as much as 3. Often, people prefer a difference between their inhale pressure versus their exhale pressure of 4 or 5 or more, which would require a bi-level machine.

So a bi-level Auto machine may be perfect, but they are more expensive and I think insurance will usually not cover bi-level machines unless you have first tried to use a non-bilevel CPAP or APAP and were not able to be "compliant" (not able to get used to it), and/or you have a fairly high pressure prescription, like 15 (cmH2O) or higher.

Both ResMed and Philips Respironics make great bi-level auto-titrating machines (ResMed VPAP Auto or Philips Respironics BiPAP Auto with Bi-flex).

Below the bi-level class of machines are the APAP machines like the ResMed AutoSet or Philips Respironics System One Auto), but ResMed EPR is more comfortable than Philips Respironics A-flex (used with APAP machines) or Philips Respironics C-flex (used with CPAP machines).

Unlike bi-level machines and unlike ResMed EPR, Philips Respironics A-flex and C-flex both return to high pressure WELL BEFORE you finish exhaling. Philips Respironics bilevel machines using Bi-flex, however, are different and (like ResMed machines) let you finish exhaling completely before raising the pressure again.

Some have reported that they found a ResMed machine too noisy and switched to a Philips Respironics machine which was much quieter. From reading different posts, I have received the impression that about half the new ResMed S9 series units are always very quiet, and the other half are very quiet at some pressures but have a slight wheeze or whistle at other pressures.

Take care,
--- Vaughn

[markrb]

Thank you very much for the information.
After reading what you have written here and having done other research I think I have decided on the machines I am going to try and the order.
If insurance will cover it the Philips BiPAP autoSV Advanced — System One would give me the best chance of success, especially if the ramp is turned on.
Otherwise I would try the the S9 Autoset with the ramp turned on.

Now on to the mask. I will search and if I don't find a post that fits my needs start a new post.

Again thanks so much,
Mark

[markrb]

I just tried to call Philips Respironics for simple product information and they wouldn't even talk to me.
That is just ridiculous. I just wanted to know two things.

1. Is the BiPAP autoSV Advanced — System One the only auto BiPAP they currently sell?
2. What is the maximum time the ramp can be set to come to full pressure? All the manual says is 1,2,3. There is no explanation of what these relate to.



At least with ResMed they have a very easy to understand compare chart with all the information on their website.

Can anyone here answer these two questions for me?

Thanks,
Mark